KEVIN MONTGOMERY (NPI# 1194372292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194372292 |
| Entity Type | Individual |
| Full Name | KEVIN MONTGOMERY |
| Practice Address |
2434 S Eason Blvd Tupelo MS 38804-6942 |
| Practice Telephone | 6626404595 |
| Practice Fax Number | 6626806416 |
| Mailing Telephone | 6626404595 |
| Mailing Fax Number | 6626806416 |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2019-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00018203 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497196166 | Kevin M Montgomery | Occupational Therapist | 946 Goss Ave Apt 5101, Louisville, KY 40217-2284 | 2013-07-10 |
| 1033770573 | Kevin Michael Montgomery | Emergency Medicine | 981150 Nebraska Medical Ctr, Omaha, NE 68198-1150 | 2019-06-25 |
| 1881154375 | Kevin Maxwell Montgomery | Student in an Organized Health Care Education/Training Program | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2019-03-21 |
| 1790242147 | Kevin Thomas Montgomery | Case Manager/Care Coordinator | 2803 Akron Rd, Wooster, OH 44691-7904 | 2019-02-21 |
| 1073023636 | Kevin Montgomery | Counselor | 2993 Sandy Plains Rd Ste 110, Marietta, GA 30066-4695 | 2017-10-09 |
| 1457659658 | Kevin Montgomery | Social Worker | 4300 Sw 13th St, Gainesville, FL 32608-4006 | 2011-03-11 |
| 1033275573 | Kevin L Montgomery | Physical Therapist | 1114 Commons Blvd, Reading, PA 19605-3333 | 2006-12-29 |
| 1962448639 | Kevin Farrell Montgomery | Surgery | 125 130th St Se, Everett, WA 98208-6400 | 2006-06-21 |
| Street Address |
2434 S EASON BLVD |
| City | TUPELO |
| State | MS |
| Zip Code | 38804-6942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508893074 | Ross E Collins Jr. | Psychiatry & Neurology | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2006-06-28 |
| 1245831551 | Lisa Roberts | Registered Nurse | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-11-03 |
| 1295336519 | Kyra Neal | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-11-03 |
| 1124635354 | Kecia Williams | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-10-01 |
| 1144837675 | Daniele Nolan | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-29 |
| 1639786163 | Reagan Bartley | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-29 |
| 1033725056 | Moesha Banks | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-16 |
| 1891301719 | Makinley Neighbors | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-16 |
| 1073129094 | Stephanie Johnson | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-16 |
| 1275149197 | Hallie Goodson | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548874159 | Susan Me'chelle Oliver | Nurse Practitioner | 874 Barnes Crossing Road, Tupelo, MS 38804 | 2020-09-01 |
| 1134762784 | Kimberly J Adams | Occupational Therapy Assistant | 90 Clark Ave, Tupelo, MS 38804 | 2019-10-25 |
| 1790270924 | Megan Guntharp | Occupational Therapist | 960 Commonwealth Boulevard, Tupelo, MS 38804 | 2018-06-29 |
| 1154867562 | Urologic Ambulatory Surgery Center, LLC | Clinic/Center | 3353 N Gloster Street, Suite 300, Tupelo, MS 38804 | 2017-01-09 |
| 1790235919 | Dr Scott Dickinson D.m. D. PC | Dentist | 3999 N Gloster Street, Tupelo, MS 38804 | 2016-10-12 |
| 1326496621 | Angela Estes | Occupational Therapist | County Road 1279 House#197, Tupelo, MS 38804 | 2016-05-26 |
| 1316300080 | Eric Wade Tillotson | Family Medicine | 1665 South Green Street, Tupelo, MS 38804 | 2016-03-31 |
| 1104238898 | Stella M. Johnson | Social Worker | 2292 Camelot Cir, Tupelo, MS 38804 | 2014-05-29 |
| 1821437351 | Lenka Petersen | Student in an Organized Health Care Education/Training Program | 1665 S Green St., Nmmc, Tupelo, MS 38804 | 2013-06-18 |
| 1083966303 | Jessica M Baskett | Counselor | 398 E Main St, Tupelo, MS 38804 | 2012-10-10 |
| Find all providers in zip 38804 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013107770 | Natalier Nicole White | Counselor | 252 Veteran Blvd., Tupelo, MS 38801 | 2007-07-30 |
| 1427660604 | Mary Trout | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-08-19 |
| 1598377756 | Haley Lackey | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-08-19 |
| 1386256568 | Anna Michael | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-08-19 |
| 1770193583 | Brianna Far | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-08-06 |
| 1285244145 | Tiffany Hooks | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-08-05 |
| 1679183529 | James Newsom | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-08-05 |
| 1669029401 | Robynn Christopherson | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2019-08-26 |
| 1780230193 | Lena Clardy | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2019-08-12 |
| 1750844338 | Emily Thomas | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2019-04-10 |
| Find all providers in TUPELO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.